Fatigue and abnormal liver values are often mentioned together, but the link is less direct than many people think. Liver problems can cause tiredness, but tiredness is a very general complaint with countless causes. Only in combination with other signals do your liver values gain meaning.
This article explains when fatigue can be liver-related, and when you are better off looking at other causes.
Are fatigue and liver values related?
Sometimes yes, often no. In advanced liver disease, fatigue occurs, but in the early phase, such as early fatty liver, the liver usually causes no symptoms (Younossi et al., 2016). A mildly abnormal value is therefore rarely the explanation for long-term tiredness on its own.
To understand what an abnormal value means, read understanding liver values.
When do abnormal liver values point to a liver problem?
The combination of factors counts. Your doctor looks at how strongly the value is raised, whether several enzymes deviate at once, and the pattern, such as the ASAT to ALAT ratio (Botros & Sikaris, 2013). A repeat test after 4 to 6 weeks shows whether the deviation is persistent.
Other causes of fatigue with abnormal values
Abnormal liver values do not have to stem from disease. Common, harmless explanations:
- Intense exercise - heavy training can raise ASAT in particular for days due to muscle damage, with fatigue as a side effect (Pettersson et al., 2008).
- Alcohol - disrupts your sleep and raises gamma-GT.
- Medications - some drugs cause both tiredness and higher liver values.
- Other causes of tiredness - anaemia, thyroid problems, sleep deprivation or stress are unrelated to the liver.
What can you do yourself?
Examine the basics: enough sleep, less alcohol, healthy food and exercise. If your values and energy improve, the cause was probably lifestyle. If complaints persist, further investigation is sensible.
Want a clear picture? The Vital Check liver function test measures your liver values, with review by a doctor.
When to see your doctor?
Make an appointment for persistent, unexplained fatigue combined with abnormal liver values, or for symptoms such as jaundice, dark urine, weight loss or pain in the upper right of your abdomen.
Frequently asked questions
Can a fatty liver cause fatigue?
It is sometimes reported, but in the early phase fatty liver usually causes no symptoms. With advanced fat or inflammation, fatigue is more likely.
Do mildly elevated liver values always cause symptoms?
No, usually not. Many people with a mildly raised value feel fine. That is precisely why deviations are often found incidentally in the blood.
How long until liver values recover?
With a lifestyle cause, often weeks to a few months. With alcohol, values usually normalise within 2 to 4 weeks of stopping.
References
- Younossi ZM, et al. Global epidemiology of nonalcoholic fatty liver disease - meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016. PubMed
- Botros M, Sikaris KA. The de Ritis ratio: the test of time. Clinical Biochemist Reviews. 2013. PubMed
- Pettersson J, et al. Muscular exercise can cause highly pathological liver function tests in healthy men. British Journal of Clinical Pharmacology. 2008. PubMed
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